Care homes in Slovakia

1. Which laws apply to opening care homes?

Principal regulation: Act No. 448/2008 Coll. on Social Services, as amended.

2. Is the care home operator required to have a presence in the local jurisdiction?

Foreign entities must have a branch established in Slovakia. An individual person can operate a care home if he/she is: (i) a citizen of a member state of the EEA and has permanent residency in Slovakia; or (ii) a foreigner and is not a citizen of an EEA member state but has temporary or permanent residency in Slovakia. 

No. Care homes can be established as privately or publicly owned, the latter by self-governing regions municipalities. 

4. How are the governing bodies of the care home regulated? 

The governing bodies of a care home depend on its form of incorporation.

The governing bodies of a privately-owned care home must comply with the relevant legislation on private companies under Slovak law.

5. Is a concession or approval by any regulatory authority required to open a care home?

The operator of a care home must be registered in the Register of Social Service Providers kept by each self-governing region. Registration is subject to the fulfilment of certain statutory criteria including educational and organisational requirements.

6. Is a care home restricted in the performance of activities on the local market?

No, however public subsidies may be awarded to care home operators that provide social welfare services on a non-profit basis.

7. Are there any restrictions on how care homes may use their profits?

No, but in specific cases, e.g. when financing for the care home is provided by the Ministry of Labour, Social Affairs and Family, certain restrictions apply which relate to care home operators that provide social welfare services on a non-profit basis. 

8. Does the government provide any type of subsidy?

The government may partially subsidise the accommodation fee.

The actual amount of the subsidy depends on the socio-economic status of the customers. Fee subsidies are also awarded by self-governing regions and municipalities.

9. Is there a supervisory authority in relation to the activities of the care home?

The Ministry of Labour, Social Affairs and Family of the Slovak Republic supervises the activities of care homes and can perform on-site inspections as part of the supervision process. Supervision can also be carried out by self-governing regions and municipalities. Specific aspects relating to the operation of care homes are subject to supervision by other state authorities, e.g. regional public healthcare authorities.

10. What is the number of inhabitants?

~5.45m (source: World Bank)

11. What is the number of inhabitants older than 65 (in %)?

15.62% (source: World Bank)

12. What is the number of care homes?

507 (source: World Bank)

13. Is there a waiting list?

There are no reliable statistics because Slovakia has both private and publicly owned care homes. The waiting time therefore varies.

14. What institutions regulate and monitor the health and social care services?

The institutional framework of supervision of social services and healthcare is rather complicated, with various institutions involved. Under current legislation the main supervisory body of the social services providers and senior housing providers is the Ministry of Labour, Social Affairs, and Family of the Slovak Republic (“Ministry of Labour”). Supervision is also carried out by higher territorial units and municipalities. In addition, the Health Care Surveillance Authority, The Public Health Authority and its regional public authority health offices, and district and regional headquarters of the Fire and Rescue Service are responsible for supervising respective specific aspects of social services. 

The Ministry of Labour supervises compliance with this Act No. 448/2008 Coll. on social services and other applicable legislation in relation to:

  • the provision of social services and the manner of their implementation, in particular in terms of compliance with fundamental human rights and freedoms;
  • the conclusion of contracts for the provision of social services
  • compliance with the obligations arising from the contract for the provision of a social service;
  • the performance of accredited professional activities 

The municipalities and higher territorial units, which themselves provide social services and senior housing, also participate in supervision of social services provision. The authorized employee of the municipality and the authorized employee of the higher territorial unit shall control the fulfilment of the conditions for registration in the register of social services providers during the provision of a social service and the obligations of the social service provider and the management of the social service provider with the provided funding. 

District and regional headquarters of the Fire and Rescue Service carry out supervision of fire protection requirements in provision of social services and senior housing. 

The Public Health Authority, manages, controls and coordinates the execution of state administration carried out by regional public health offices, which are responsible for public health, including for example Covid-19 pandemic measures. The main areas of focus of those inspections include compliance of the social provider’s compliance with:

  • operating rules previously approved by the the Public Health Authority
  • hygiene-epidemiological operating regime
  • level of cleanliness and order, compliance with hygiene requirements
  • level of material equipment (including the compliance with barrier-free needs) 
  • the nutrition and nutritional status of the elderly (including the nutritional value of the meals).

The Public Health Authority is very active in relation to auditing social services provision, with an average of approximately 1 300 inspections per year.

The Health Care Surveillance Authority carries out the supervision over provision of health care and public health insurance. In relation to social services provision, the Health Care Surveillance Authority oversees the proper provision of nursing care and deals with cases regarding supervision of health care provision and public health insurance issues. The Health Care Surveillance Authority carries out only few inspections in this area per year, mainly because the Health Care Surveillance Authority does only act upon outside reports and thus, unlike the Public Health Authority it does not carry out preventive inspections. 

New legislation on the topic in the legislative process 

Interestingly, draft Act intended to improve the quality of inspections of social services is currently in the legislative process. Pending the outcome of the legislative process, the Ministry of Labour is supposed to establish a special unit that will be responsible for carrying out inspections of provision of social services. Strengthened staff capacity will increase the frequency and bring systematicity to the conduct of inspections. The newly created inspection unit is expected to have a total of 180 staff operating in all regions by 2024.

The main responsibilities of the newly introduced Social Inspection Unit will be to:  

  • perform administrative supervision over the fulfilment of obligations in the application of social security law in defined areas by supervised entities, including compliance with quality standards of social services provided, fulfilment of other obligations in the field of social services, the obligation to use the monetary allowance granted to compensate for the social consequences of severe disability in a purposeful manner, the quality and scope of assistance to a people with severe disability for which a monetary allowance for personal assistance or care is provided and fulfilment of obligations in the implementation of measures for the social protection of children and social guardianship;
  • exercise liability for breaches of the obligations of social services providers